Silent reflux may be the cause of sleep disturbances in patients with unexplained sleep disorders

Nov 1 2005

Patients with sleep complaints but no heartburn symptoms suffered episodes of nighttime acid reflux according to research presented at the 70th Annual Scientific Meeting of the American College of Gastroenterology.

In a separate study, researchers found that symptoms of gastroesophageal reflux (GER) are common and frequently severe in patients with obstructive sleep apnea.

Patients with gastroesophageal reflux commonly report poor sleep, waking at night because of acid reflux. Some individuals who have respiratory problems exacerbated by acid reflux may frequently be without symptoms of heartburn. In a study of 81 patients with documented sleep complaints at least three nights per week who underwent polysomnographic sleep evaluations, 26 percent had acid reflux. Of those who suffered with reflux, 94 percent of the recorded reflux events were associated with arousal from sleep or awakening.

"These are patients without significant heartburn symptoms, who are experiencing acid reflux during sleep," explained William C. Orr, Ph.D. of Lynn Health Science Institute in Oklahoma City, OK. "'Silent reflux' may be the cause of sleep disturbances in patients with unexplained sleep disorders."

In another study on GERD and sleep presented by researchers at Duke University Medical Center at the ACG Annual Scientific Meeting, GER symptoms were common and frequently severe in 168 patients undergoing sleep studies who reported symptoms consistent with sleep apnea. These patients had frequent daytime and nighttime heartburn symptoms. Those with sleep apnea reported much lower quality of life on a self-administered questionnaire. Those patients with sleep apnea who also reported moderate to severe nighttime GER reported even worse quality of life.

"All patients with sleep apnea should be evaluated for gastroesophageal reflux," said J. Barry O'Connor, M.D., of Duke University Medical Center, one of the investigators.